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HomeMy WebLinkAboutLAFEVER ELECTRIC, INC.- 001271- 10/21/2010 CARMEL REDEVELOPMENT COMMISSION 001271 LaFever Electric, Inc. Check: 1271 131 N Rangeline Road Date: 10/21/2010 Carmel, IN 46032 Vendor: LAFEVER1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 1 4460847-2 13,632.30 13,632.30 1,107.00 0.00 12,525.30 Application 1 2-1 4460847-3 38,834.10 38,834.10 0.00 0.00 38,834.10 App 1 on power packages P47 168609 342.62 - 342.62 0.00 0.00 342.62 2 receptacles for portalet 52,809.02 52,809.02 1,107.00 0.00 51,702.02 6' iTHIS CHECK4HASiAECOLOREDIBACKGROUNDIANDICONTA.INSIMULTIEWE[SECURITaY,EEATURESj-"eSEEIBACK1EORIDETA1LS 6II M pP,1g&DEy.�c Carmel Redevelopment Commission REGIONS 001271 . 30 West Main Street • Suite 220 2o•ia2li�ao O/S CARMEL Carmel, IN 46032 TR%R1L 1271 DATE • AMOUNT 10/21/2010, ************51,702:02 PAY. THE SUM OF FIFTY ONE THOUSAND SEVEN HUNDRED TWO DOLLARS AND 02 CENTS TO THE ORDER • OF LaFever Electric, Inc. 131 N Rangeline Road jSE"S, Carmel, IN 46032 e m I, 7'GiRFA TO'P - ,II 00L27LII' 1:0740L42L31: 0087 SOLI LLLII' CARMEL REDEVELOPMENT COMMISSION 001271 LaFever Electric, Inc. Check: 1271 131 N Rangeline Road Date: 10/21/2010 Carmel, IN 46032 Vendor: LAFEVER1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paic 1 4460847-2 13,632.30 13,632.30 1,107.00 0.00 12,525.3( Application 1 2-1 4460847-3 38,834.10 38,834.10 - 0.00_ , 0.00 38,834.1( App 1 on power packages P47 168609 342.62 342.62 0.00 0.00 342.6; 2 receptacles for portalet 52,809.02 52,809.02 1,107.00 0.00 51,702.0: INVOICE L,o,FEVER ELECTRIC, inc. 131 NORTH RANGELINE ROAD • CARMEL, IN 46032 • (317)846-4687 • FAX(317)844-7943 Commercial and Industrial Contractors SOLD Carmel Redevelopment Commission TO INVOICE DATE 9/23/2010 30 West Main Street, Suite 220 Carmel, Indiana 46032 168609 Attention: Account Payable REF.OUR ORDER DELIVER Carmel Vendor TO REF.YOUR ORDER TERMS NET 30 DAYS QUANTITY DESCRIPTION UNIT PRICE AMOUNT Provide (2) receptacles for portalet trailer hook-up. $342.62 Director of Redevelopment MS-9003 PAST DUE INVOICES ARE SUBJECT TO A FINANCE CHARGE OF 1-1/2% PER MONTH. ORDER DAIR PROJECT FIELD ORDER ELECTRIC, INC. JDiND. I lliLlJ �llJ 1\ 131 N. RANGELINE ROAD 1686 11 958 CARMEL, INDIANA 46032 Carmel Vendor ER (317) 846 -4687 CHARGE TO DATE ORDER UA I E CONTRACT Carmel Redevelopment Commission RECD REQUESTED AMOUNT OF ADDRESS DESCRIPTION BE DP Provide(2)receptacles for portalet trailer hook-up. CITY AND STATE: ADDITIONAL WORK AUTHORIZED BY: OWNER'S REPRESENTATIVE- DA I ES AND HOURS WORKMAN'S NAME CLASSI- 19-Oct TOTAL HOURS RATE AMOUNT FICATION MON TUE WED THU FRI SAT SUN Josh Garvey (Dbl. T) 2 2.00 143.00 286.00 TOTAL LABOR - - - - - - 2.00 - 286.00 QUAN DESCRIPTION UNIT PRICE P AMOUNT FOR BILLING PURPOSES ONLY LABOR 2 4 Square Deep 1/2 &3/4 J-Box 72.83 C 1.46 % INSURANCE 2 Single Outlet 20A Receptacle 2.42 E 4.84 %OVERHEAD 2 Round Hole Raised Cover for 4 Square Box 0.72 E 1.43 2 3/4" Chase Nipple 0.25 E 0.51 PROFIT 2 1 Pole 30A Bolt-in Type BL Breaker 16.09 E 32.19 %INDIANA GROSS TAX 30 #10 THHN 144.69 M 4.34 TOTAL LABOR 286 00 MATERIAL 44 76 - - Continuation Sheet(s) 15%OVERHEAD 6 71 - 51 47 - - 10%PROFIT 5 15 56 62 1/2%INDIANA GROSS TAX - - 56 62 7% INDIANA SALES TAX TOTAL MATERIAL 56 62 TAX EXEMPTION NO.: TOTAL MATERIAL 44.76 TOTAL LABOR&MATERIAL 342 62 FOREMAN: Approved OWNER'S REPRESENTATIVE _..,... ` `,71„/ G7O2TM-�'�°= Document G702 - 1992 Application and Certificate for Payment TO OWNER: Cannel Redevelopment Comm. PROJECT: Parcel 47 Service APPLICATION NO: 1 Distribution to: 30 West Main Street, #220 1st Street NW PERIOD TO: 9/30/2010 OWNER 0 Carmel, Indiana 46032 Carmel, Indiana 46032 CONTRACT FOR: ARCHITECT ❑ FROM CONTRACTOR: VIA ARCHITECT.: CONTRACT DATE: CONTRACTOR ❑ LaFever Electric, Inc. SO 131 N. Rangeline Road 280 East 96th Street, Suite 100 PROJECT NOS: 1?40 / FIELD ❑ Carmel, Indiana 46032 Indianapolis, Indiana 46240 OTHER ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information Application is made for payment,as shown below,in connection with the Contract. and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for Continuation Sheet,AIA Document G703,is attached. which previous Certificates for Payment were issued and payments received from the Owner, and• 1.ORIGINAL CONTRACT SUM $ 35.052.00 that current payment shown herein is now due. 2. Net change by Change Orders • $ 0.00 CONTRAC L ever Electric, Inc.•3.CONTRACT SUM TO DATE(Line 1 ±2) $ 35,052.00 By: V 4 Date: 9/22/2010 4.TOTAL COMPLETED&STORED TO DATE(Column on State of: yfidiana Michael A. LaFever,Vice-President • TO CO (C G o G703) $ 13,632.30 , 5.RETAINAGE: County of: Hamilton. • a. 10 %of Completed Work Subscribed and sworn to before \`uutninuunuu (Column D+Eon G703) $ 1,042.00 me this 22nd ay:o' S .,,, ..;-Tr, r '�I p�...... ........... Colleen S. Marvel b. 10 To of Stored Material /• (Column F on G703) $ 65.00 Notary Public . ? 6' A••ri 1, 201 1,107.00 My Commissi ex • . __ I. Total Retainage(Lines 5a+5b or Total in Column I of G703) $ J �., _ 6.TOTAL EARNED LESS RETAINAGE $ 12,525.30 ARCHITECT'S CERTI f CATE"FOR PAYMENT (Line 4 Less Line 5 Total) In accordance with the Contract D'ch�um&it ,,bas0'd or `Ate observations and the data comprising 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 0.00 this application, the Architect certif`tytoA}' 6 to the best of the Architect's knowledge, information and belief the Work has flftrggis.W gas indicated, the quality of the Work is in (Line 6 from prior Certificate) accordance with the Contract Documents, and the Contractor is entitled to payment of the 8.CURRENT PAYMENT DUE $ 12,525.30 AMOUNT CERTIFIED. 9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIF • $/2 62rj_'1 b (Line 3 less Line 6) $ 22,526.70 (Attach expla atior if amount certified differs from the amount applied. Initial all figures on this Application and o the C. tinuation Sheet that are changed to conform with the amount certified.) CHANGE ORDER SUMMARY - ADDITIONS DEDUCTIONS ARCHIT T: Total changes approved in previous months by Owner $ 0 $ 0 By: , If.,4/ , Date: 01910 Total approved this Month $ 0 $ 0 This Certificate is not negotiable.The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 0 $ 0 named herein. Issuance,payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ 0 the Owner or Contractor under this Contract CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G7021M—1992.Copyright ©1953,1963,1965,1971,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA® Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. - Director of Redevelopment/ -''=AIJLV Document G7-O2TM— 1992 Instructions Application and Certificate for Payment GENERAL INFORMATION Purpose and Related Documents AIA Document G702, Application and Certificate for Payment, is to be used in conjunction with AIA Document G703, Continuation Sheet.These documents are designed to be used on a Project where a Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Document A20I, General Conditions of the Contract for Construction. Use of Current Documents Prior to using any AIA Contract Document, users should consult www.aia.org or a local AIA component to verify the most recent edition. Reproductions This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA. There is no implied permission to reproduce this document, nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G702, but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software. Licensed AIA software users should consult the End User License Agreement(EULA). To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects' legal counsel,copyright @aia.org. COMPLETING THE G702 FORM After the Contractor has completed AIA Document G703,Continuation Sheet, summary information should be transferred to AIA Document G702,Application and Certificate for Payment. • The Contractor should sign G702,have it notarized, and submit it,together with G703, to the Architect. The Architect should review G702 and G703 and, if they are acceptable,complete the Architect's Certific e for Payment on G702. The Architect may certify a different amount than that applied for, pursuant to Sections 9.5 and 9.6 of A201:The Architect should then initial all figures on G702 and G703 that have been changed to conform to the amount.certified and attach an explanation.The completed G702 and G703 should be forwarded to the Owner. MAKING PAYMENT The Owner should make payment directly to the Contractor based on the amount certified by the Architect on AIA Document G702,Application and Certificate for Payment.The completed form contains the name and address of the Contractor.Payment should not be made to any other party unless specifically indicated on G702. EXECUTION OF THE DOCUMENT Persons executing the document should indicate the capacity in which they are acting(i.e., president, secretary, partner,etc.)and the authority under which they are executing the document. Where appropriate, a copy of the resolution authorizing the individual to act on behalf of the firm or entity should be attached. 4.. iL• r. • AIA Document G702TM—1992.Copyright©1953,1963, 1965;1971,1978,1983 and 1992 by The American Institute of*Architects.All rights reserved. WARNING:This AIA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. JOB NAME Parcel 47 Alternate APPLICATION DATE 9/22/2010 PAGE NUMBER 1 APPLICATION NUMBER 1 PERIOD TO 9/30/2010 A B C D I E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE NO. VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G=C) TO FINISH APPLICATION STORED AND STORED (C-G) (D+E) (NOT IN TO DATE D OR E) (D+E+F) 1 Conduit M 1,000.00 - 350.00 650.00 1,000.00 100 - 100.00 L 3,200.00 - 1,120.00 1,120.00 • 35 2,080.00 112.00 2 Directional Bore @ Main&2nd Ave 8,350.00 - - - 8,350.00 - 3 Directional Bore @ Main& 1st Ave 10,705.00 - - - 10,705.00 - 4 Directional Bore @ 1st St& 1st Ave 8,550.00 - 8,550.00 8,550.00 100 - 855.00 5 Payment and Performance Bond 400.00 - 400.00 400.00 100 - 40.00 4 Change Order#1 2,847.00 - - 2,562.30 90 284.70 - M - - - - - L - - - - - M - - - - - M - - - - - - L - - - - M - - - - - - L -- - - - M - - - - - -L - - - - - M - L - - - - - M - L - - - - - M - - - - - - L -- - - - M - - - - - - L - - - - - 35,052.00 - 10,420.00 650.00 13,632.30 21,419.70 1,107.00 WAIVER OP LIEN TO DATE Stars Of Indiana }ss County of Hamilton 1 File d: TO WHOM rr M I Y CO uagieri WHEREAS the undersigned has k„employed by LaFever Electric,Inc. noedoa'm apoidrrw511 omme — m famish E1 ical Work for the poonisos described as Parcel 4.7 Service �-Qll�lm!Me i.T ,Klseelsrw�nr ofwhlch, Carmel Redevelopment Commission _ is the maw Twelve Thousand Five Hundred Twenty-five Dollars and Thirty Cents THE undersigned,tar and in consideration of (g 12,525.30 j Dollars,and Other good and valuable cormidaation,the rooeipt Whereof is Mx xby arknov$edged,do(cs)hacby waive and release any and tell lien or claim or right of lien under the Senates of the Steno wherein the land is located,relating to I&eaniels liens.on the above described premises end improvements thereon,and on the meatier or ether enesidivationo due or to beamee due from the owner,on woman of labor or services,material,Soma or ejipamhrs hmetedwe fhrnlshed to this data by the undersigned for the above described pwmtase. Wined this 22nd day September .20 10 .l 1- Michael A. LaFever, Vice-President sal NOTE:All wavers meat be for the NT amount paid.If waiver is for a eorpmxtion,corporate name should be mad,corporate seal affixed and tins of o(lcar three waiver should be set fortbt if weber is for a partnership,the partnership mete should he used.partner should dr and denigrate Mending pare, CONTRACTOR'S AFFIOAvIt State of Indiana }ss County of Hamilton TO WHOM IT MAT CONCERN: undersigned,being duly ewcm deposes and says that he Is Vice-President of LaFever Electric,Inc. who is the contractor for the_ Electrical Work Work CM the bedding located at 1st Street 1\1W,Carmel,Indiana 46032 .� owned by arms eve o.ment ommission . That the total amount of the contrast indediag cares 15 S 35,052.00 on 1 Mich he has received payment of S 0.00 prior to this motet.That all waive re are true,cDrme t mid genuine and delivt red unconditionally and that Beene is no clehn either legal or equitable to&h et the validity of said waivers.That the following are the names of all parties win have fbmtshcd mearlai or labor,or both,fits said work and all parties having contracts or suheon rams for speoldo portions ofsaid work or for material eatmimg Into the coast racoon Mae(sind the a nottin Pm or w hove= due to cook and dose the kW;mentioned iamluded all labor and material ed m crnu said work according to dan9 and ■ons: CR+a? r►.. ... . lip` • lane Mahurm Eorepro S I) 2-62-581'/ irecronal kioring 27,603.00 0 1 11111111111iTEM IMO IMTi7.O TOTA LAa1rl La MAYaittAL YO CCfMIPtfl 11111311-TWill Linaltil i That done dams a be done upon fur sad weds outstanding,end dirt dices 4a na hleg dac or to become due to any polo e .• nets rrat,tabor or other wok o may kind pot or in connocdon with said work other than above stated. shamed this 22nd ddy of September ,20 10 Michael A. LaFever Vice Presidentt...._._ Subsoribod and sworn to bcforeDme thta 22nd day of .20 10 .,a,; TS1 CD1606i7/2007 • O e arv- SEAL *_ 1111fit,i;Fii:10 ei t7,..0: A Document G702TM — 1992 Application and Certificate for Payment TO OWNER: Carmel:Redevelopment Comm. PROJECT: Parcel 47 Service APPLICATION NO: 1 Distribution to: 30West Main Street, #220 1st Street NW PERIOD TO: 9/30/2010 OWNER ❑ Carmel, Indiana 46032 Cannel, Indiana 46032 CONTRACT FOR: ARCHITECT ❑ FROM CONTRACTOR. VIA ARCHITECT.: CONTRACT DATE: CONTRACTOR ❑ LaFever Electric, Inc. SO 131 N. Rangeline Road 280 East 96th Street, Suite 100 PROJECT NOS: 1%40 h FIELD ❑ Carmel, Indiana 46032 Indianapolis, Indiana 46240 OTHER ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information Application is made for payment,as shown below,in connection with the Contract. and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for Continuation Sheet,AIA Document G703,is attached. which previous Certificates for Payment were issued and payments received from the Owner, and 1.ORIGINAL CONTRACT SUM $ 63,149.00 that current payment shown herein is now due. 2. Net change by Change Orders $ 0.00 CONTRAC •R: La f ver Electric, Inc. 3.CONTRACT SUM TO DATE(Line 1 ±2) $ 63,149.00 By: / L Date: 9/22/2010 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 43,149.00 State of: Indiana Michael A. LaFever, Vice-President 5.RETAINAGE: County of: Hamilton a. 10 %of Completed Work Subscribed and sworn to befo �0011 10/0,,,, (Column D+Eon G703) $ 3,894.90 me this 22nd , of .,``` Q, elq: 4,• 2010 b. 10 %of Stored Material �f�,.• / Colleen S. Marvel (Column F on G703) $ 420.00 Notary Public: ;-•' 111,V018 018 4 314.90 My Commissio • e3=--: Total Retainage(Lines 5a+5b or Total in Column I of G703) $ , = . AL . *E 6.TOTAL EARNED LESS RETAINAGE $ 38,834.10 ARCHITECT'S AR ICATE WV AYMENT (Line 4 Less Line 5 Total) In accordance with the Co'> racy •oc,ut)len `e on on-site observations and the data comprising 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 0.00 this application, the Archite f'lt \ Owner that to the best of the Architect's knowledge, information and belief the Woi• 1tWHI r6gressed as indicated, the quality of the Work is in (Line 6 from prior Certificate) accordance with the Contract Documents, and the Contractor is entitled to payment of the 8.CURRENT PAYMENT DUE $ 38,834.10 AMOUNT CERTIFIED. 9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED $W, 634- I o (Line 3 less Line 6) $ 24,314.90 (Attach eiplanat• n if c mount ce tilled differs from the amount applied. Initial all figures on this Application a don th ,1:11._._on Shet that are changed to conform with the amount certified.) CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT.Total changes approved in previous months by Owner $ 0 $ 0 By: / Date: q/ID1(0 Total approved thisiMonth $ 0 $ 0 This Certificate is not negotiable.The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 0 $ 0 named herein. Issuance,payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract NET CHANGES by Change Order $ 0 CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G702TM—1992.Copyright ©1953,1963,1965,1971,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA® Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright@aia.org. WI Director of Redevelopment l'/y(00e =-114IA Document G702 TM- 1992 Instructions Application and Certificate for Payment GENERAL INFORMATION Purpose and Related Documents AIA Document G702, Application and Certificate for Payment,is to be used in conjunction with AIA Document G703,Continuation Sheet.These documents are designed to be used on a Project where a Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Document A201,General Conditions of the Contract for Construction. Use of Current Documents Prior to using any AIA Contract Document,users should consult www.aia.org or a local AIA component to verify the most recent edition. Reproductions This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document, nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G702, but only for use in connection with a particular project. The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software. Licensed AIA software users should consult the End User License Agreement(EULA). To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects' legal counsel,copyright @aia.org. COMPLETING THE G702 FORM After the Contractor has completed AIA Document G703, Continuation Sheet, summary information should be transferred to AIA Document G702,Application and Certificate for Payment. The Contractor should sign G702,have it notarized, and submit it, together with G703, to the Architect. • The Architect should review G702 and G703 and, if they are acceptable,complete the Architect's Certificate for Payment on G702. The Architect may certify a different amount than that applied for, pursuant to Sections 9.5 and 9.6 of A201.The Architect should then initial all figures on G702 and G703 that have been changed to conform to the amount certified and attach an explanation. The completed G702 and G703 should be forwarded to the Owner. MAKING PAYMENT The Owner should make payment directly to the Contractor based on the amount certified by the Architect on AIA Document G702, Application and Certificate for Payment. The completed form contains the name and address of the Contractor.Payment should not be made to any other party unless specifically indicated on G702. EXECUTION OF THE DOCUMENT Persons executing the document should indicate the capacity in which they are acting(i.e., president, secretary, partner,etc.)and the authority under which they are executing the document. Where appropriate, a copy of the resolution authorizing the individual to act on behalf of the firm or entity should be attached. AIA Document G702TM—1992.Copyright©1953,1963,1965,1971,1978, 1983 and 1992 by The American Institute of Architects.All rights reserved. WARNING:This AIA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. JOB NAME Parcel 47 Service APPLICATION DATE 9/22/2010 PAGE NUMBER 1 APPLICATION NUMBER . 1 PERIOD TO 9/30/2010 A B C D I E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE NO. VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G=C) TO FINISH APPLICATION STORED AND STORED (C-G) (D+E) (NOT IN TO DATE D OR E) (D+E+F) - 1 Conduit M 4,000.00' - 4,000.00 - 4,000.00 100 - 400.00 L 10,340.00 - 10,340.00 10,340.00 100 - 1,034.00 2 Wire M 14,800.00. - - - - 14,800.00 - L 4,600.00 - - - 4,600.00 - 3 Termination Cabinet M 4,200.00 - - 4,200.00 4,200.00 100 - 420.00 L 600.00 - - - 600.00 - 4 Excavation 15,000.00 - 15,000.00 15,000.00 100 - 1,500.00 5 Payment and Performance Bond 600.00 - 600.00 600.00 100 - 60.00 6 Allowance 5,000.00 - 5,000.00 5,000.00 100 - 500.00 7 Change Order#1 4,009.00 - 4,009.00 4,009.00 100 - 400.90 M - - - - - L - - M - - - - L - - - - - - M - - - - - L - M - - - - L - M - _ - - - L - M - _ L - - - M - _ L - - - _- 63,149.00 - 38,949.00 4,200.00 43,149.00 20,000 00 4,314 90 WAIVER OIL LIEN TO DATE State of Indiana Inn County of Hamilton Pile TO WHOM rl'MAY Ct0Nciatm W}EREA$the undersigned has bees eatpleyad hY _LaFever Electric, Inc. • new t ewna.Cwsaetr at gplaMtneer totiut►fstt Elgctrical Work Ibr the premises described as Parcel 47 Service Caws Aatrenarlrlrltlaaa➢e! II ofAi&_ — Carmel Redevelopment Commission is the owe na.aere.aar rut u7dctsigneo { Q lei h T usend Eight Hundred Thirty-four Dollars and Ten Cent (S 38,834.0 )DONS,and other pod and valuable constdcrapWn,the receipt whereof is het;by acknowledged,du(cs)!tatty waive and releoae any and ell lien or claim or right of lien under the Stamm of the Stem who teln the land is located.redoing to 1 dechanlcs tip on the above described premises And irnprovemetts thereon,and on the mottle;or ether considerations due or to become due from the owner,on seaman of labor or services,material,foams or nppm'atus haatolbre iiniehed to this date by the undersigned for the shove deamibed premises. slgted this 22nd day of September ,z0 10 Michael A. LaFever, Vice-President NoTlbr All waivers meat be fbr the foil amount paid.If waiver is fora corporation,corporate tame should be sled,corporate real aPtbeed and rite of owker eignlug waiver should be set forth;If waiver is for a partnership,the partnership ante should he teed,partner should edge and designate himself in partner. CONTRACTOR•S AFFIOAVIT State of Indiana )SS County of Hamilton 1„ TO WHOM IT MAY CONCERN: undergigrosd,being duty sworn,deposes and says that he is Vice-President of LaFever Electric,Inc. whole the contractor fear the Electrical Work work on the banding located at st treet I1 W-Carmel Indiana 46032 owned by arme •e e eve o s ment ommission That the totes amount of the contrast inatnding extras is$ 63,149.00 on vhich he has received payment of g 0.00 prior to this payment.net an waivers are sue,ooireot and genuine and delivered unconditionally and that there is no claim either legal or equitable to dafbat the validity of said waivers.That the following aro the names of all parties who have tunnelled material or labor,Or both,for said work and all patsies having coon=or aubaonuacia for speckle portions of said work or for material altering into the coital ruction thereof and the amount due or to become dad to • and that the hau s mentioned included all labor and material = to --Said work nee to Ilona mid --:. one: maws • mho OF WORK } it e'" PR i.:.Y �: '.i :P r e I�Y7►•>S.:i��Jf i[sTiFlll:a 15 000.11 1.11 r`1� Ti.T ri'.T rid ,T; ; W.:, r -.• �[.Xrtl>�[IT11♦ thorn etc no other contracts fbr said work outstanding,and as there is n. ;.g duo or to became due to soy pars°t m. - tabor or other work o any kind done or to be done upon or in conneedon with said work other than above stated. &sand thle 22nd day of September Michael A. L vet Yee-President_ - b Subscribed end sworn to before tat this 22nd day of September ,2 10 . - 1 '��ii Coll �iarvel.... TSI CD18 06n007 G, 11 A